FORM 2 [See Rule 10] FORM OF APPLICANT FOR …

1 form 2 [See Rul e 10] form OF APPLICANT F OR THE GRANT OF LEARNER'S LICENCE To The Licensing Authority, .. Space for passpor t size photograph I hereby apply for a licence authorising me to drive as a learner, the following motor vehicle(s):- (a) Motor cycle without gear (b) Motor cycle with gear (c) Invalid carriage (d) Light Motor vehicle (e) Transport vehicle (f) Road roller (g) Motor vehicle of a specified description, namely .. PARTICULARS TO BE FURNISHED BY APPLICANT Name: .. of: .. 3. Permanent address(Electoral Roll / Life Insurance Policy / Passpo rt / Pay slip issued by any office of the Central Government/ State Government or a local body / Any other document or documents as may be prescribed by the State Government / Affidavit sworn before an Executive Magistrate or a First Class Judicial Magistrate or a Notary Public to be enclosed).

2 4. Temporary address/ Official address, if any: .. of stay at the present address: .. 6. Date of birth(Birth certificate / School certificate / Affidavitsworn before an Executive Magistrate or a FirstClass Judicial Magistrate or a Notary Public to beenclosed): .. of birth: .. 8. If plac e of birth outside India, when migrated toIndia: .. 9. Educational Qualification: .. mark(s): 11. Omitted vide 708(E) dated for passpor t size photograph 12. Blood group: RH (Rhesus) factor: hold an effective driving licence to drive:Motor cycle/light motor vehicle/transport39 .. vehicle with effect from: .. 14. Particulars of any driving licence previouslyheld by APPLICANT .: Whether it was cancelled and if so, for whatreason: 15.

3 Particulars of any learner s licence previouslyheld by APPLICANT in respect of the description ofvehicle to which the APPLICANT has .. 16. Have you been disqualified for holding orobtaining driving licence or learner s licence. If: .. so, for what reasons.: .. 17. I enclose three copies of my recent photograph(passport size photograph): .. 18. I enclose medical fitness certificate (doctor).19. I have submitted along with my earlier application for learner s licence / I enclose the written consent ofparen t/guardian (in the case of APPLICANT being a minor). enclose driving certificate (Name and address of the driving school).21. I have paid the fee of am exempted from the medical test under Rule 6 of the Central Motor Vehicles rules , am exempted from the preliminary test under Rule 11(2) of the Central Motor Vehicles rules , 1989.

4 *Strike out whichever is Signature or thumb impression of APPLICANT Specimen signatures or thumb impression of APPLICANT Declaration under sub-section (2) of section 7 of the Motor Vehicles Act, 1988 Shri/ .. Son / daughter of .. who is a minor is under my care and I accept responsibility for his/her driving. If at a later date I decide not to accept responsibility for his/her driving I shall intimate the licensing authority in writing for the cancellation of the licence. I give my consent for his/her obtaining learner s licence. Name and full address of the parent .. (To be si gned in the presence of the licensing authority or person authorized in this behalf by the licensing authority). For office use The APPLICANT is exempted from the medical test under Rule 6 and the preliminary test under Rule 11(2) of the Central Motor Vehicles rules , 1989.

5 Learner s Licence may be issued. The APPLICANT was tested with reference to Rule 11(1) of the Central Motor Vehicles rules , 1989. He has passed the test. Learner s Licence may be issued. Learner s Licence may be refused. *Strike out whichever is of licensing authority or other person authorised in this behalf. The application along with the scanned copies of the required documents may also be sent to the concerned Licensing Authority through Electronic Mail, if allowed by the concerned State Government / Union Territory Administration. In such cases, the Licensing Authority shall scrutinise the application and intimate the APPLICANT about the acceptance/any discrepancy. In case the application is accepted, the APPLICANT shall be intimated through El ectronic Mail to report to the Authority concerned on an appointed date along with the documents for further verification, submission of application fee and examination of the APPLICANT .

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